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Periodontitis Patients (periodontitis + patient)
Kinds of Periodontitis Patients Selected AbstractsSerum IgG to heat shock proteins and Porphyromonas gingivalis antigens in diabetic patients with periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2002Tom J. Sims Abstract Background: Past studies have reported a correlation between the presence and severity of periodontitis and serum antibody titers to species-specific antigens of Porphyromonas gingivalis or to cross-reactive antigens, such as lipopolysaccharide (LPS) and heat shock proteins (HSP), shared between P. gingivalis and other bacteria. Our recent study of periodontal treatment outcome in insulin-dependent (type 1) diabetes mellitus patients with severe periodontitis (IDDMI/periodontitis) resulted in two key findings: 1. serum glutamic acid decarboxylase autoantibody (GAD65 Ab) levels were significantly associated with periodontal pocket depth change (PDC) and 2. serum IgG titers to P. gingivalis cells were positively associated with GAD65 Ab level in seropositive (GAD65 Ab +) patients. We have therefore hypothesized that profiles of serum autoantibody levels and IgG titers, to P. gingivalis -specific antigens may be useful in assessing risk for refractory periodontitis in such patients. Aim: To determine whether PDC resulting from non-surgical periodontal treatment can be predicted using profiles of baseline IgG titers to P. gingivalisspecific antigens, human HSP, and GAD65. Methods: PDC was assessed two months after non-surgical periodontal treatment of 7 GAD65 Ab + and 11 GAD65 AbIDDM/periodontitis patients. Pretreatment titers to GAD65, recombinant human heat shock proteins (HSP90, HSP70, and HSP60), and various P. gingivalis antigens were measured using radioligand precipitation or enzyme-linked immunosorbent (ELISA) assays and compared to the same measurements for 154 recent-onset IDDM patients and 46 non-diabetic controls. Results: Median titers (ELISA units) to HSP90 and HSP70 were significantly higher than non-diabetic controls for GAD65 Ab + (p°= 0.002) and GAD65 Ab- (p =,0.034) IDDM/periodontitis patients, respectively. Multivariate regression analysis indicated significant partial correlation of PDC with log-transformed titers to HSP90 (r =,, 0.62, p = 0.008), HSP70 (r =,+ 0.62, p = 0.009), GAD65 (r =,, 0.60, p = 0.01) and P. gingivalis LPS (r = , 0.5 1, p = 0.04). Furthermore, hierarchical clustering of baseline profiles of log-transformed HSP90, HSP70, and GAD65 Ab titers sorted patients into two distinct clusters with significantly different median PDC (1.45 min, n = 10 vs. 0.65 min, n = 8; p = 0.016, Mann,Whitney). Conclusion: Pretreatment profiles of serum antibody titers to HSP90, HSP70, GAD65, and P. gingivalis LPS may be useful for predicting which patients with IDDM/periodontitis will have a poor response to non-surgical periodontal therapy. [source] Microbiology of destructive periodontal disease in adolescent patients with congenital neutropeniaJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2000A report of 3 cases Abstract Background, aims: Congenital neutropenia is one condition that may predispose for destructive periodontal disease at a young age. In this report, we describe the microbiology of 3 adolescent patients with congenital neutropenia two of whom suffered from severe periodontitis. Method: Microbiological testing of the parents was also performed in 1 case. DNA fingerprinting was used to study transmission of putative periodontal pathogens in this case. From 1 patient with periodontitis, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis were isolated; a 2nd periodontitis patient was infected with P. gingivalis. A 3rd patient had gingivitis only and no A. actinomycetemcomitans or P. gingivalis were found. Results: Using the amplified fragment length polymorphism DNA fingerprinting technique, bacterial transmission between the father and a patient was shown for A. actinomycetemcomitans but not for P. gingivalis. [source] Tooth extraction decision model in periodontitis patientsCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2010A. Popelut Abstract Objective: The purpose of this study was to build, around several types of input data, a decision analysis model for dental extraction strategy in periodontitis patients. Materials and methods: The decision analysis was based on the following scenario: a fictitious adult chronic periodontitis patient with no chief complaint, being referred to make a decision of extraction on one single tooth presenting a periodontal defect that may affect the decision-making process. A decision tree was used to identify the treatment options within the next 5 years. Scientific evidences were based on probabilities given by a literature analysis using a systematic approach. Clinical expertize was based on subjective utilities (SUs) assigned by an experts' panel. Expected utilities (EUs) were used to rank the following options: no treatment (EU1) or periodontal treatment (EU2); extraction followed by a tooth-supported fixed partial denture , FPD , (EU3) or an implant-supported single crown , ISC , (EU4). Results: The robustness analysis calculation indicates that the probability of tooth survival needed to be equal to 0.78 in order that the passive option becomes optimal. However, EU1 was impossible to calculate due to the lack of available probabilities. The EU intervals were 79,96, 86,89 and 94,95 for EU2, EU3 and EU4, respectively. Consequently, the FPD option is dominated by the ISC option, and it is not possible to conclude to a difference between the periodontal and the ISC therapy. Conclusions: Within the limits of this model, tooth extraction followed by FPD is the worst strategy compared with ISC or periodontal therapies. To cite this article: Popelut A, Rousval B, Fromentin O, Feghali M, Mora F, Bouchard P. Tooth extraction decision model in periodontitis patients. Clin Oral Impl Res. 21, 2010; 80,89. [source] Genotype variation and capsular serotypes of Porphyromonas gingivalis from chronic periodontitis and periodontal abscessesFEMS MICROBIOLOGY LETTERS, Issue 1 2007Takashi Yoshino Abstract Porphyromonas gingivalis is considered an important pathogen in periodontal disease. While this organism expresses a number of virulence factors, no study combining different virulence polymorphisms has, so far, been conducted. The occurrence of combined virulence (Cv) genotypes in 62 isolates of P. gingivalis was investigated from subjects displaying either chronic periodontitis or periodontal abscess. The Cv genotypes, based on gene variation of fimbriae (fimA), Lys-specific cystein proteinase (kgp) and Arg-specific cystein proteinase (prpR1/rgpA), were evaluated by PCR. The isolates were also subjected to capsular polysaccharide K-serotyping. A total of 18 Cv genotype variants based on fimA: kgp: rgpA were identified, of which II:I:A and II:II:A Cv genotypes (53.3%) were the two most frequently detected combinations. Moreover, 36% of the isolates were K-typeable, with the K6 serotype being the most prevalent (23%). Two isolates had the same genotype as the virulent strain W83. The results indicate that chronic periodontitis is not associated with a particularly virulent clonal type. A highly virulent genotype (e.g. strain W83) of P. gingivalis can be found in certain periodontitis patients. [source] Post-treatment effects of subantimicrobial dose doxycycline on clinical parameters and gingival crevicular fluid transforming growth factor-,1 in severe, generalized chronic periodontitisINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 2 2008A Gürkan Abstract:, Objective:, Present study aimed to evaluate the effect of 3-month adjunctive subantimicrobial dose doxycycline (SDD) on clinical parameters and gingival crevicular fluid (GCF) transforming growth factor-beta1 (TGF-,1) levels in chronic periodontitis patients over 12 months. Methods:, Thirty-five patients with severe, generalized periodontitis participated in the present randomized, placebo-controlled study. Patients received scaling and root planing (SRP) plus 3 months adjunctive SDD or placebo. Clinical measurements and GCF sampling were performed at baseline, 3, 6, 9 and 12 months. Eleven periodontally healthy subjects served as controls for GCF TGF-,1 analysis. Results:, Clinical parameters of both SDD and placebo groups significantly improved during the study (P < 0.0125). SDD group exhibited significantly higher PD reduction at deep sites (baseline PD ,7 mm) compared with placebo group at 6 months (P < 0.05). In SDD group significantly higher percentage of deep pockets resolved (PD reduction ,3 mm from baseline) when compared with placebo group at 6 and 9 months (73.4% versus 49.7%; 79.9% versus 50.6%, respectively, P < 0.05). PD reduction ,4 mm for deep pockets from baseline was also greater in SDD group than placebo at 6 months (53.4% versus 36.3%, P < 0.05). GCF TGF-,1 levels of SDD group was significantly higher than baseline (P < 0.0125) and placebo group (P < 0.017) at 3 months. Conclusions:, These results ensure further data for beneficial effects of adjunctive SDD therapy in the management of severe chronic periodontitis. [source] The effect of topical doxycycline usage on gingival crevicular fluid MMP-8 levels of chronic and aggressive periodontitis patients: a pilot studyINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2006Abstract:, The aim of this study was to evaluate the efficacy of topical subgingival application of doxycycline hyclate (DH) gel adjunctive to non-surgical periodontal therapy on gingival crevicular fluid (GCF) matrix metalloproteinase (MMP)-8 levels in chronic and aggressive periodontitis patients. Forty teeth of 10 chronic periodontitis patients and 32 teeth of eight aggressive periodontitis patients were screened for 6 months. Scaling and root planing (SRP) was applied to the control sites and DH gel adjunctive to SRP was applied to the test sites of each patient simultaneously. GCF MMP-8 levels were analysed at baseline, 7 days; and at 1, 3 and 6 months by Sandwich Elisa Method. At 1, 3 and 6 months, probing depth (P < 0.0051) and plaque scores and bleeding on probing values (P = 0.000) significantly decreased in each group when compared with the baseline, but there was no statistically significant difference between the test and control sites. GCF MMP-8 levels reduced presenting statistically significant differences on 7 days, 1, 3 and 6 months in four of the groups (P < 0.05); however, intergroup differences were not statistically significant. Developing functional and immunological-based chair-side MMP tests might serve as useful adjunctive diagnostic tools when monitoring the effects of DH gel application. [source] Regenerative treatment with platelet-rich plasma combined with a bovine-derived xenograft in smokers and non-smokers: 12-month clinical and radiographic resultsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2010Selcuk Yilmaz Abstract Aim: The purpose of this study was to assess the healing response of intrabony defects following regenerative treatment with platelet-rich plasma (PRP) combined with a bovine-derived xenograft (BDX) in smokers and non-smokers. Materials and Methods: A total of 24 advanced chronic periodontitis patients, 12 smokers and 12 non-smokers, with 113 intrabony defects with an intrabony component of 3 mm were included in this study. Defects were surgically treated with PRP/BDX. At baseline and 12 months after surgery, the following parameters were recorded: plaque and sulcus bleeding indices, probing depth (PD), relative attachment level, marginal recession, probing and radiographic bone levels. Results: Considering the soft tissue measurements, smokers and non-smokers presented a mean PD reduction of 3.97 ± 0.76 and 4.63 ± 0.52 mm, recession of 0.76 ± 0.44 and 0.50 ± 0.12 mm and attachment gain of 3.26 ± 0.42 and 4.06 ± 0.40 mm, respectively. Evaluation of the hard tissue findings revealed that the mean clinical and radiographic bone gains in smokers and non-smokers were 2.83 ± 0.47 and 3.63 ± 0.38 mm, 2.98 ± 0.38 and 3.67 ± 0.48 mm, respectively. Inter-group differences for PD reduction (p<0.05), attachment (p<0.001), clinical (p<0.001) and radiographic bone gains (p<0.001) were found to be significant between smokers and non-smokers. Conclusions: Within the limits of this study, the results indicate that treatment outcome following PRP/BDX application in intrabony defects is impaired with smoking. [source] Involvement of vascular endothelial growth factor, CD44 and CD133 in periodontal disease and diabetes: an immunohistochemical studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 1 2009Guendalina Lucarini Abstract Aim: The aim of this study was to investigate the relationship between expression of angiogenic and regeneration markers and periodontal disease in subjects with/without diabetes mellitus. Material and Methods: Immunohistochemical detection of vascular endothelial growth factor (VEGF), CD44 and CD133 was performed in 16 samples each of (1) healthy gingiva from non-diabetic subjects (controls), (2) gingiva from non-diabetic subjects with periodontitis, (3) gingiva from subjects with type 1 diabetes and periodontitis, (4) gingiva from subjects with type 2 diabetes and periodontitis. Results: Diseased gingivae from patients with diabetes and periodontitis had greater clinical measures of periodontal disease than those with periodontitis only. VEGF expression was significantly enhanced in epithelial and endothelial cells from patients with periodontitis compared with controls (p<0.05). Epithelial CD44 expression was strong in all groups, while CD44 was significantly enhanced (p<0.05) in connective tissue cells from both diabetic groups. Epithelial and endothelial CD133 expression was comparable in all patients except those with type 2 diabetes and periodontitis, where it was not detected. Stromal CD133 expression was significantly lower in patients with type 2 diabetes and periodontitis and was increased in periodontitis patients (p<0.05). Conclusions: The involvement and high expression of VEGF, CD44 and CD133 in periodontal disease may predict a greater regeneration capacity of gingival tissue. [source] Mannose-binding lectin gene polymorphisms in relation to periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2008Anna Louropoulou Abstract Aim: To investigate the correlation of six functional polymorphisms in the MBL gene with MBL plasma levels in relation to periodontitis. Material and Methods: A total of 92 periodontitis patients and 70 controls, all of Caucasian origin, were included. Patients and controls were genotyped for the L/H, X/Y, P/Q, A/D, A/B and A/C polymorphisms. Distributions of genotypes, rate of allele carriage and allele frequencies were compared between patients and controls. Patients and controls were subdivided in groups of genotypes. Plasma MBL levels were compared between different genotype groups. Results: On the basis of genotyping, three phenotypes with regard to mannose-binding lectin (MBL) production were distinguished: high-producers, low-producers and deficient subjects. No differences in the genotype frequencies were observed between patients and controls. Within patients and controls, subjects with the high-producing genotypes had significantly higher MBL plasma levels than low-producers and deficient subjects (p<0.001). Plasma MBL was higher in low-producer patients compared with low-producer controls (padjusted=0.021). Conclusion: No association could be observed between MBL gene polymorphisms and susceptibility to periodontitis in Caucasians. However, now that genotyping could distinguish the low producing and deficient subjects from the high-producers, it was observed, for the first time, that MBL acts as a weak acute-phase protein in periodontitis. [source] Saliva concentrations of RANKL and osteoprotegerin in smoker versus non-smoker chronic periodontitis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2008Nurcan Buduneli Abstract Objectives: To compare the salivary receptor activator of NF- ,B ligand (RANKL) and osteoprotegerin (OPG) concentrations in smokers versus non-smokers with chronic periodontitis. Material and Methods: Whole saliva samples were obtained from 67 untreated chronic periodontitis patients, of whom 34 were smokers, and from 44 maintenance patients, of whom 22 were smokers. Full-mouth clinical periodontal measurements were recorded. Saliva cotinine, sRANKL and OPG concentrations were determined by ELISA. Statistical analysis was performed using the Mann,Whitney U test, Bonferroni's correction for multiple comparisons and Spearman's correlations. Results: Untreated smokers exhibited significantly higher values of clinical periodontal recordings than untreated non-smokers (all p<0.05). Salivary cotinine level correlated with clinical attachment level (p=0.023). Smoker versus non-smoker maintenance groups showed no significant differences in clinical parameters. There were significant differences in sRANKL and OPG concentrations between untreated and maintenance groups (all p<0.01). Salivary OPG concentration was significantly lower (all p<0.01) and the sRANKL/OPG ratio was higher (all p<0.01) in smokers than in non-smokers. OPG concentration correlated positively with probing depth, clinical attachment level and bleeding on probing (all p<0.005) and negatively with pack-year, and cotinine level (p<0.05). Conclusion: Salivary RANKL and OPG concentrations are suggested to be affected by smoking as not only the untreated but also the treated smokers exhibited higher RANKL and lower OPG concentrations than non-smokers. [source] Genotypic characterization of Porphyromonas gingivalis isolated from subgingival plaque and blood sample in positive bacteremia subjects with periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2008P. Juliana Pérez-Chaparro Abstract Aim: The objective of this study was to investigate clonal relationship among Porphyromonas gingivalis isolated from subgingival plaque and blood samples in positive transient bacteremia subjects with periodontitis. Material and Methods: Unrelated patients with general chronic periodontitis or general aggressive periodontitis requiring scaling and root planing (SRP) were included in the study. Genotyping of each isolate was performed using pulsed field gel electrophoresis technique. Genetic relatedness of strains isolated within an individual or between different patients was determined by dendogram analysis. Results: Following SRP, from 16 patients, seven patients showed positive P. gingivalis bacteremia and nine were negative. Thirty-two strains were isolated from subgingival plaque and blood samples before and during induced transient bacteremia. The majority of the patients harboured one clonal type. Two patients showed different clones in plaque and blood samples suggesting that more than one clone can be found in subgingival plaque. P. gingivalis isolates from periodontitis patients after transient bacteremia following SRP, revealed a high heterogeneity among isolates. Conclusion: In 6/16 subjects the same P. gingivalis isolate was found in the blood and in oral cavity. P. gingivalis heterogeneity suggests no association of a unique clonal type with transient bacteremia. [source] Formation of osteoclast-like cells from peripheral blood of periodontitis patients occurs without supplementation of macrophage colony-stimulating factorJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2008Stanley T. S. Tjoa Abstract Aim: To determine whether peripheral blood mononuclear cells (PBMCs) from chronic periodontitis patients differ from PBMCs from matched control patients in their capacity to form osteoclast-like cells. Material and Methods: PBMCs from 10 subjects with severe chronic periodontitis and their matched controls were cultured on plastic or on bone slices without or with macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor- ,B ligand (RANKL). The number of tartrate-resistant acid phosphatase-positive (TRACP+) multinucleated cells (MNCs) and bone resorption were assessed. Results: TRACP+ MNCs were formed under all culture conditions, in patient and control cultures. In periodontitis patients, the formation of TRACP+ MNC was similar for all three culture conditions; thus supplementation of the cytokines was not needed to induce MNC formation. In control cultures, however, M-CSF or M-CSF/RANKL resulted in higher numbers compared with cultures without cytokines. Upregulations of osteoclast marker mRNA cathepsin K and carbonic anhydrase II confirmed the osteoclastic character. Bone resorption was only observed when PBMCs were cultured in the presence of M-CSF and RANKL. Conclusion: Our data indicate that PBMCs from periodontitis patients do not need priming by M-CSF to become osteoclast-like cells, suggesting that PBMCs from periodontitis patients are present in the circulation in a different state of activity. [source] Subgingival microbial profiles in chronic periodontitis patients from Chile, Colombia and SpainJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2008David Herrera Abstract Aim: To investigate the subgingival microbiota of distinct periodontitis patient populations, in Chile, Colombia and Spain, using identical clinical and bacteriological methods. Material and Methods: In this multicentre study, 114 chronic periodontitis patients were selected. Patients were examined using an identical clinical protocol and pooled subgingival samples were obtained from each patient. Samples were processed in the three laboratories by means of culturing under identical clinical and microbiological protocols. Total anaerobic counts and frequency of detection and proportions of nine periodontal pathogens were calculated. Variables were analysed by means of anova, ,2, Kruskal,Wallis and Dunn's multiple comparison tests. Results: The Colombian population demonstrated greater severity of periodontitis, with significantly deeper mean probing pocket depth, and had a significantly lower percentage of current smokers. When comparing samples from the three patient populations, the total counts were significantly higher in the Colombian patients. The numbers of putative pathogens differed among groups. Tannerella forsythia was found less frequently in Chilean samples, while Parvimonas micra and enteric rods differed significantly among the three population groups. Conclusion: Significant differences among Chile, Colombia and Spain existed regarding the frequency and proportions of specific periodontal pathogens in the subgingival microbiota of periodontitis patients. [source] Incomplete adherence to an adjunctive systemic antibiotic regimen decreases clinical outcomes in generalized aggressive periodontitis patients: a pilot retrospective studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2007Adrian Guerrero Abstract Aim: The objective of this study was to explore the effect of incomplete adherence to the prescribed antibiotic regimen, amoxicillin and metronidazole, in the non-surgical treatment of generalized aggressive periodontitis (GAP). Methods: This retrospective study included 18 GAP subjects who received a conventional course of full-mouth non-surgical periodontal treatment using machine-driven and hand instruments and an adjunctive course of systemic antibiotics (500 mg amoxicillin and 500 mg metronidazole three times a day for 7 days). Clinical parameters were collected at baseline and at 2 months post-treatment. Self-reported adherence to the prescribed medication regimen was recorded at 2 months. Results: All clinical parameters, except for the mean clinical attachment level (CAL) in sites with initial probing pocket depth (PPD) 3 mm, improved at 2 months in all subjects. PPD reduction was 3.7 mm [95% confidence interval (CI) 3.2, 4.3 mm] in deep pockets (7 mm) and 2.2 mm (95% CI 1.9, 2.4 mm) in moderate pockets (4,6 mm), while CAL gain was 2.2 mm (95% CI 1.7, 2.6 mm) and 1.2 mm (95% CI 0.8, 1.5 mm), respectively. However, only 11 subjects (61.1%) reported full adherence to the medication. In deep pockets (7 mm), the difference between an adherent and non-adherent/partially adherent subject was 0.9 mm (95% CI 0.1, 1.7 mm, ancova, p=0.027) in PPD reduction and 0.8 mm (95% CI ,0.2, 1.9, p=0.129) in CAL gain at 2 months. In moderate pockets (4,6 mm) this difference was smaller in magnitude: 0.4 mm (95% CI 0.1, 0.9 mm, p=0.036) in PPD reduction and 0.2 mm (95% CI ,0.3, 0.9 mm, p=0.332) in CAL gain. Conclusions: Within the limits of this design, these data suggest that incomplete adherence to a 7-day adjunctive course of systemic metronidazole and amoxicillin is associated with decreased clinical outcomes in subjects with generalized aggressive periodontitis. [source] Comparison of gingival blood flow during healing of simplified papilla preservation and modified Widman flap surgery: a clinical trial using laser Doppler flowmetryJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2007M. Retzepi Abstract Aim: This prospective randomized-controlled clinical trial compared the gingival blood flow responses following simplified papilla preservation (test) versus modified Widman flap (control). Materials and Methods: Twenty contra-lateral upper sites with pocket depth 5 mm after initial treatment in 10 chronic periodontitis patients were randomly assigned to either test or control treatment, using a split-mouth design. Laser Doppler flowmetry recordings were performed pre-operatively, following anaesthesia, immediately post-operatively and on days 1, 2, 3, 4, 7, 15, 30 and 60, at nine selected sites per flap. Results: Significant ischaemia was observed at all sites following anaesthesia and immediately post-operatively. At the mucosal flap basis, a peak hyperaemic response was observed on day 1, which tended to resolve by day 4 at the test sites, but persisted until day 7 at the control sites. The buccal and palatal papillae blood perfusion presented the maximum increase on day 7 in both groups and returned to baseline by day 15. Both surgical modalities yielded significant pocket depth reduction, recession increase and clinical attachment gain. Conclusions: Periodontal access flaps represent an ischaemia,reperfusion flap model. The simplified papilla preservation flap may be associated with faster recovery of the gingival blood flow post-operatively compared with the modified Widman flap. [source] Compromised GCF total antioxidant capacity in periodontitis: cause or effect?JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2007I. L. C. Chapple Abstract Background: Oxidative stress is implicated in the pathogenesis of periodontitis. The total antioxidant capacity (TAOC) of gingival crevicular fluid volume (GCF) and plasma appears compromised in periodontitis, but it is unclear whether this predisposes to, or results from the inflammatory process. Aim: To investigate longitudinal changes in GCF and plasma TAOC following reductions in periodontal inflammation with successful non-surgical therapy. Materials and Methods: Two longitudinal studies were run in series on non-smokers with chronic periodontitis (CP). Study-1 (n=17) assessed index sites with mild disease; Study-2 (n=18) investigated deep sites. GCF sampling and clinical measures were performed at baseline and 3 months post-therapy. Plasma and GCF TAOC was determined by enhanced chemiluminescence and 32 age/sex-matched periodontally healthy controls were used. Results: Therapy improved clinical outcomes consistent with the literature. There were no differences in plasma TAOC between periodontitis patients (507±92 ,MTeq) and controls (520±100 ,MTeq; p=0.57) at baseline, but GCF TAOC was lower (p<0.0001) in CP patients (680±371 ,MTeq) than controls (1129±722 ,MTeq). Successful periodontal therapy did not alter plasma TAOC (p=0.56), but GCF TAOC increased (by 449±722 ,MTeq, p<0.001) to control subject levels (p=0.47) Conclusions: Local total antioxidant capacity in CP appears to reflect increased oxygen radical activity during periodontal inflammation and can be restored to control subject levels by successful non-surgical therapy. [source] Fc, receptor polymorphisms and periodontal status: a prospective follow-up studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2006D. L. Wolf Abstract Aims: The aims of this study were to assess: (i) the distribution of Fc, receptor polymorphisms among patients with chronic periodontitis ("cases") and control subjects with no/minimal loss of periodontal tissue support in a Caucasian population; (ii) whether these polymorphisms can serve as severity markers for periodontitis; and (iii) whether they have any bearing on the response to periodontal therapy. Methods: The study sample consisted of 132 cases and 73 controls of comparable age and gender. Full-mouth periodontal status was assessed. Subgingival plaque (PL) samples and blood samples were obtained and analysed with respect to 19 bacterial species and homologous serum immunoglobulin G titres. Polymorphisms in the Fc, receptor IIa (131R/H) and IIIb (NA1/NA2) were assessed by polymerase chain reaction. Patients underwent periodontal therapy and were followed up at 4 and 30 months. Results: Neither polymorphism showed a skewed distribution among cases and controls. At baseline, periodontitis patients with Fc, RIIa-H/H131 genotype had more PL and deeper pockets than patients in other genotype groups (p<0.05). Both bacterial levels and antibody titres were unrelated to genotype. The longitudinal analysis failed to detect an association between genotype and response to periodontal therapy. Conclusions: The present data failed to demonstrate a clinically relevant relationship between the Fc, receptor IIa (131R/H) or IIIb (NA1/NA2) polymorphism and periodontal status. [source] Clinical and microbiological effects of different antimicrobials on generalized aggressive periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2006Christiana Xajigeorgiou Abstract Aim: To evaluate and compare the effects of adjunctive metronidazole plus amoxicillin, doxycycline and metronidazole on clinical and microbiological parameters in patients with generalized aggressive periodontitis. Material and Methods: Forty-three patients participated in this randomized clinical trial divided into four groups. Six weeks after scaling and root planning (SRP), groups 1,3 received adjunctive metronidazole, plus amoxicillin, doxycycline and metronidazole respectively, and group 4 acted as controls. Clinical recordings concerning probing depth, probing attachment level and bleeding on probing were performed at baseline, 6 weeks after SRP and 6 months from baseline. Subgingival samples were analysed using the ,checkerboard' DNA,DNA hybridization for Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Tannerella forsythia and Treponema denticola. Results: All treatments resulted in improvement of clinical parameters (ANOVA p>0.05). Systemic administration of metronidazole plus amoxicillin or metronidazole resulted in statistically significant greater reduction of the proportion of sites > 6mm than SRP (z -test, p<0.05). These antimicrobials yielded a significant effect on levels of important periodontal pathogens for 6 months. Conclusion: Adjunctive metronidazole plus amoxicillin or metronidazole alone (when A.actinomycetemcomitans is not involved) is effective in deep pockets of aggressive periodontitis patients. [source] Hyper-reactive mononuclear cells and neutrophils in chronic periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2006A. Gustafsson Abstract Objectives: Stimulated mono- and polymorphonuclear cells from patients with periodontitis have shown increased release of interleukin-1, (IL-1,) and oxygen radicals, respectively. The aim was to study whether this hyper-reactivity could be found both in mono- and polymorphonuclear cells from the same patient, and whether there was a relation to the gene coding for IL-1, (IL-1,+3953). Material and Methods: Peripheral mononuclear cells from 14 non-smoking and well-treated patients and pair-matched controls were incubated with opsonized Staphylococcus aureus and lipopolysaccharide (LPS). Released IL-1, and tumour necrosis factor (TNF)- , were determined with ELISA. Generation of oxygen radicals from the Fc, -receptor-stimulated neutrophils was measured with chemiluminescence and the polymorphism at IL-1,+3953 was measured with polymerase chainreaction. Results: The mononuclear cells from the patients released more IL-1, after incubation with LPS (p<0.001) and with bacteria (p<0.05). The release of TNF- , tended to be higher in the patient group. The peripheral neutrophils from the patients generated more oxygen radicals (p<0.06). We found no differences between the study groups regarding the IL-1,+3953 polymorphism. Conclusion: The similarity in systemic inflammation between patients and controls suggests that the increased release/generation of IL-1, and oxygen radicals from peripheral leukocytes in periodontitis patients is of a constitutional nature and of pathogenic relevance. [source] Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in the Netherlands and SpainJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2005A. J. Van Winkelhoff Abstract Background and Aim: Antimicrobial resistance of periodontal pathogens towards currently used antibiotics in periodontics has been investigated in a previous study. Microbial resistance in the periodontal microflora was more frequently observed in Spanish patients in comparison with Dutch patients. The aim of the present study was to compare antimicrobial susceptibility profiles of five periodontal bacteria isolated from periodontitis patients in Spain and in the Netherlands. Material and Methods: Subgingival plaque samples from adult patients with periodontitis were collected and cultured on selective and non-selective plates. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum and Micromonas micros were isolated and used for minimal inhibitory concentration tests using the Epsilometer (E-test) technique. Eight different antibiotics were tested on all bacterial isolates. MIC50 and MIC90 values for each antibiotic and each species were determined and the percentage of resistant strains was calculated. Results: Significantly higher MIC values were noted in Spanish strains of F. nucleatum for penicillin, ciprofloxacin, of P. intermedia for penicillin, amoxicillin and tetracycline, of M. micros for tetracycline, amoxicillin and azithromycin, and of P. gingivalis for tetracycline and ciprofloxacin. Based on breakpoint concentrations, a higher number of resistant strains in Spain were found in F. nucleatum for penicillin, amoxicillin and metronidazole, in Prevotella intermedia for tetracycline and amoxicillin, and in A. actinomycetemcomitans for amoxicillin and azithromycin. Resistance of P. gingivalis strains was not observed for any of the antibiotics tested both in Spain and the Netherlands. Conclusions: Differences exist in the susceptibility profiles of periodontal pathogens isolated from periodontitis patients in Spain and in the Netherlands. This implicates that antibiotic susceptibility testing is necessary to determine efficacy of antimicrobial agents. Also, clinical studies with antibiotics should take these differences into account. The information from the present study indicates that it may not be possible to develop uniform protocols for usage of antibiotics in the treatment of severe periodontitis in the European Union. [source] Antibiotic resistance profile of the subgingival microbiota following systemic or local tetracycline therapyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2004Rosa Maria J. Rodrigues Abstract Background: Tetracyclines have been extensively used as adjunctives to conventional periodontal therapy. Emergence of resistant strains, however, has been reported. This study evaluated longitudinally the tetracycline resistance patterns of the subgingival microbiota of periodontitis subjects treated with systemic or local tetracycline therapy+scaling and root planing (SRP). Methods: Thirty chronic periodontitis patients were randomly assigned to three groups: SRP+500 mg of systemic tetracycline twice/day for 14 days; SRP alone and SRP+tetracycline fibers (Actsite®) at four selected sites for 10 days. Subgingival plaque samples were obtained from four sites with probing pocket depths (PPD)6 mm in each patient at baseline, 1 week, 3, 6 and 12 months post-therapy. Samples were dispersed and diluted in pre-reduced anaerobically sterilized Ringer's solution, plated on Trypticase Soy Agar (TSA)+5% blood with or without 4 ,g/ml of tetracycline and incubated anaerobically for 10 days. The percentage of resistant microorganisms were determined and the isolates identified by DNA probes and the checkerboard method. Significance of differences among and within groups over time was sought using the Kruskal,Wallis and Friedman tests, respectively. Results: The percentage of resistant microorganisms increased significantly at 1 week in the tetracycline groups, but dropped to baseline levels over time. The SRP+Actsite® group presented the lowest proportions of resistant species at 6 and 12 months. No significant changes were observed in the SRP group. The predominant tetracycline-resistant species included Streptococcus spp., Veillonela parvula, Peptostreptococcus micros, Prevotella intermedia, Gemella morbillorum and Actinobacillus actinomycetemcomitans (Aa). A high percentage of sites with resistant Aa, Porphyromonas gingivalis and Tanerella forsythensis was observed in all groups at baseline. However, T. forsythensis was not detected in any group and P. gingivalis was not present in the SRP+Actsite® group at 1 year post-therapy. Aa was still frequently detected in all groups after therapy. However, the greatest reduction was observed in the SRP+Actsite® group. Conclusion: Local or systemically administered tetracycline results in transitory selection of subgingival species intrinsically resistant to this drug. Although the percentage of sites harboring periodontal pathogens resistant to tetracycline were quite elevated in this population, both therapies were effective in reducing their prevalence over time. [source] Quadrant root planing versus same-day full-mouth root planingJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2004II. Microbiological findings Abstract Objectives: The aim of this study was to test the hypothesis that over a period of 6 months, same-day full-mouth scaling and root planing (FM-SRP) resulted in greater reductions in the detection frequency of five putative periodontal pathogens compared with quadrant scaling and root planing (Q-SRP) in chronic periodontitis patients. Materials and Methods: Forty patients were recruited into this study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant root planing at 2-weekly intervals over four consecutive sessions. Selected-site analyses were performed on the deepest site in each quadrant before and after therapy, at approximately 3 and 6 months from baseline (R1 and R2) and clinical indices were recorded with an electronic pressure-sensitive probe. In addition, subgingival plaque samples were collected from these sites at baseline (BAS), at reassessment 1 (R1), approximately 6 weeks after the completion of therapy and at reassessment 2 (R2), 6 months from baseline. Polymerase chain reaction (PCR) was used to determine the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Treponema denticola and Bacteroides forsythus in plaque. Results: Both therapies resulted in significant improvements in all clinical indices both at R1 and R2. A marked reduction in the presence of all candidate periodontal pathogens was noted after both treatment modalities, reaching statistical significance for the majority of the test organisms. These improvements were maintained over a period of 6 months. When the two treatment groups were compared, a significantly higher percentage of Q-SRP patients was positive for P. intermedia at R1 compared with FM-SRP patients (p<0.05). In addition, a greater reduction in the patient prevalence for T. denticola was found for the FM-SRP group than the Q-SRP group at R1 and R2 from baseline (p<0.005), but the significance of this is questionable given the skewed detection frequency of this organism at baseline between the two treatments (p<0.01). Conclusion: This study failed to confirm that same-day FM-SRP resulted in greater microbiological improvements compared with Q-SRP at 2-weekly intervals over a 6-month period, as determined by PCR. [source] Long-term effect of full-mouth tooth extraction on the responsiveness of peripheral blood monocytesJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2003Schelte J. Fokkema Abstract Background: As some residual inflammation may remain after periodontal therapy, the present pilot study investigated the long-term effect of full-mouth tooth extraction therapy on the responsiveness of peripheral blood monocytes in a case with generalized terminal adult periodontitis. Methods: Before and 3, 9, 20 and 32 months after therapy, venous blood was collected. Total and differential white blood cell counts were determined and whole blood cell cultures (WBCC) were incubated with lipopolysaccharide (LPS) to stimulate the production of inflammatory mediators by monocytes. Results: After full-mouth tooth extraction, the numbers of total peripheral white blood cells and neutrophils decreased over time. The release of the chemokines interleukin (IL)-8 and macrophage chemoattractant protein (MCP)-1 in the cultures decreased twofold over time, whereas no changes were seen for the other studied cytokines, chemokines and prostaglandin E2. Conclusion: On the basis of previous studies and the present case, the high production of IL-8 and MCP-1 by monocytes in LPS-stimulated WBCC from periodontitis patients is most likely acquired, as their levels decrease over time when the periodontal infection is controlled. The possible connection between periodontitis and atherosclerosis through IL-8 and MCP-1 is discussed. Zusammenfassung Hintergrund: Da nach der parodontalen Therapie eine restliche Entzündung zurückbleiben kann, untersucht die vorliegende Studie den Langzeiteffekt einer vollständigen Zahnextraktion auf die Ansprechbarkeit der peripheren Blutmonozyten in einem Fall mit generalisierter unheilbarer Erwachsenen-Parodontitis. Methoden: Vor und 3, 9, 20 und 32 Monaten nach der Therapie wurde venöses Blut gesammelt. Der totale und differenzierte weiße Blutzellgehalt wurden bestimmt, und eine gesamte Blutzellkultur (WBCC) wurde mit Lipopolysaccharid inkubiert, um die Produktion von Entzündungsmediatoren durch Lymphozyten zu stimulieren. Ergebnisse: Nach der vollständigen Zahnextraktion verringerte sich die Zahl der totalen peripheren weißen Blutzellen und der Neutrophilen über die Zeit. Die Freisetzung des Chemokins Interleukin 8 (IL-8) und des Makrophagen chemoattraktanten Proteins (MCP) ,1 in den Kulturen verringerte sich zweifach über die Zeit, während für die anderen beobachteten Cytokine, Chemokine und Prostaglandin E2 keine Veränderungen festgestellt wurden. Schlussfolgerung: Auf der Basis vorheriger Studien und des vorliegenden Falls ist die hohe Produktion von IL-8 und MCP-1 durch Monozyten in LPS stimulierten WBCC von Parodontitis-Patienten sehr wahrscheinlich anzunehmen, da ihr Level über die Zeit abnimmt, wenn die parodontale Infektion kontrolliert ist. Die mögliche Verbindung zwischen Parodontitis und Arteriosklerose durch IL-8 und MCP-1 wird diskutiert. Résumé Contexte: Puisqu'après traitement parodontal, une inflammation résiduelle peut subsister, cette étude se propose de rechercher les effets à long terme de l'extraction complète des dents sur la réponse des monocytes périphériques dans un cas de parodontite de l'adulte terminale généralisée. Méthodes: Des prélèvements sanguins veineux ont été réalisés avant et 3, 9, 20 et 32 mois après traitement. Les comptages totaux et relatifs des cellules blanches sanguines furent déterminés et les cultures complètes de cellules sanguines (WBCC) furent incubées avec du lipopolysaccharide pour stimuler la production des médiateurs de l'inflammation par les monocytes. Résultats: Après l'extraction complète des dents, les nombres de cellules sanguines blanches totales périphériques et des neutrophiles diminuaient au cours du temps. Le relargage des chimiokines interleukine (IL)-8 et protéine chimio-attractante du macrophage (MCP)-1 dans les cultures diminuait deux fois au cours du temps, alors qu'aucun changement n'était observé pour les autres cytokines étudiées, chimiokines et prostaglandine E2. Conclusion: Sur la base d'études préalables, et les résultats issus de ce cas présent, la forte production d'IL-8 et de MCP-1 par les monocytes dans les WBCC stimulés par le LPS chez des patients atteints de parodontite semble être vraisemblablement acquise puisque leurs niveaux diminuent lorsque l'infection parodontale est contrôlée. La relation possible entre parodontite et l'athérosclérose par IL-8 et MCP-1 est discutée. [source] Five-year maintenance follow-up of early-onset periodontitis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2003Joanna J. Kamma Abstract Objectives: The purpose of this study was to evaluate the clinical and microbiological status of patients with early-onset or aggressive periodontitis (EOP) who had received supportive periodontal care (SPC) every 3,6 months for a period of 5 years, following active periodontal treatment. Material & Methods: The study population consisted of 25 individuals with early-onset periodontitis. Clinical examination and recordings of probing pocket depth (PPD) and clinical attachment level (CAL) were performed at baseline prior to treatment (T0), 3 months following the termination of active periodontal treatment (T1) and annually at the SPC appointments (T2,T3,T4,T5). Microbiological samples were obtained at the 5-year SPC (T5). Subgingival plaque samples for each individual were collected from one deep pocket (>5 mm), based on pretreatment measurements, randomly selected in each quadrant. The levels of Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola were determined using oligonucleotide probe hybridization. Results: During the 5-year period, the mean of SPC/patient was 12.7 sessions. A significant improvement was observed in PPD, CAL, gingival bleeding index and suppuration following treatment. However, between T1 and T5, 134 sites in 20 patients deteriorated with a CAL loss of,2 mm. Out of these 134 sites showing disease progression, microbial samples were randomly obtained in 13 sites (9.7%) from 8 patients. Among other factors, smoking and stress were found to have significant predictive value on the future attachment loss. P. gingivalis, T. denticola and total bacterial load were statistically significantly higher in patients who experienced disease progression during the 5-year maintenance period. Conclusions: For most EOP patients, regular SPC was effective in maintaining clinical and microbiological improvements attained after active periodontal therapy. However, a small percentage of sites was identified as progressive in 20 patients. Variables found to be related to periodontal progression were the presence of as well as the high bacterial counts of P. gingivalis, T. denticola and total bacterial load, number of acute episodes, number of teeth lost, smoking and stress. Zusammenfassung Erhaltungstherapie über fünf Jahre bei Patienten mit früh einsetzender Parodontitis (EOP) Ziele: Der Zweck dieser Studie war es, 5 Jahre nach aktiver Parodontalbehandlung den klinischen und mikrobiologischen Zustand von Patienten mit früh einsetzender oder aggressiver Parodontitis (EOP), bei welchen alle 3-6 Monate eine parodontale Erhaltungstherapie (SPC) erfolgte, zu evaluieren. Material & Methoden: Die Studienpopulation bestand aus 25 Individuen mit früh einsetzender Parodontitis. Die klinische Untersuchung und Aufzeichnung der Sondierungstiefe (PPD) sowie des klinischen Attachmentniveaus (CAL) erfolgten bei der Eingangsuntersuchung vor der Behandlung (T0), drei Monate nach Beendigung der aktiven Parodontalbehandlung (T1) und jährlich bei den SPC-Terminen (T2,T3,T4,T5). Die mikrobiologischen Proben wurden bei der 5-Jahres-SPC gewonnen (T5). Für jedes Individuum wurden die subgingivalen Plaqueproben in jedem Quadranten aus einer tiefen Tasche (>5mm) entnommen. Dies geschah randomisiert und auf der Grundlage der Messungen vor der Behandlung. Das Niveau von Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis und Treponema denticola wurden unter Verwendung der Hybridisierung mit Oligonukleotid-Sonden bestimmt. Ergebnisse: Während der 5-jährigen Periode betrug die mittlere Anzahl der SPC-Sitzungen pro Patient 12,7. Nach der Behandlung wurden bei PPD, CAL, Gingiva-Blutungs-Index und der Pusentleerung signifikante Verbesserungen beobachtet. Jedoch haben sich zwischen T1 und T5 bei 20 Patienten 134 Taschen mit einem CAL-Verlust von=2mm verschlechtert. Bei 8 Patienten wurden aus diesen 134 Taschen, mit Progression der Erkrankung, von 13 Taschen (9,7%) randomisiert mikrobiologische Proben entnommen. Innerhalb anderer Faktoren wurde bei Rauchen und Stress ein signifikanter Vorhersagewert für zukünftigen Attachmentverlust vorgefunden. Bei den Patienten, die in der 5-jährigen Erhaltungsperiode eine Progression der Erkrankung erfuhren lagen P. gingivalis, T. denticola und die bakterielle Gesamtbelastung höher. Schlussfolgerungen: Für die meisten EOP-Patienten die regelmäßig an der parodontalen Erhaltungstherapie teilnahmen war diese hinsichtlich der Aufrechterhaltung der nach der aktiven Parodontaltherapie erzielten klinischen und mikrobiologischen Verbesserungen erfolgreich. Jedoch wurde bei 20 Patienten ein geringer Prozentsatz von Taschen als fortschreitend identifiziert. Die Variablen, von denen gefunden wurde, dass sie eine Beziehung zur Progression haben waren: sowohl Vorhandensein von P. gingivalis, T. denticola als auch hohe Bakterienzahl von P. gingivalis, T. denticola und die bakterielle Gesamtbelastung, Anzahl der akuten Episoden, Anzahl verlorener Zähne, Rauchen und Stress. Résumé Suivi en maintenance sur 5 ans de patients atteints de parodontites d'apparition précoce. Objectifs: Cette étude se propose d'évaluer l'état clinique et microbiologique de patients atteints de parodontites d'apparition précoce ou agressive (EOP) qui furent suivis en maintenance (SPC) tous les 3-6 mois pendant une période de 5 ans après un traitement parodontal actif. Matériel & Méthodes: La population étudiée consistait en 25 individus atteints de parodontites d'apparition précoce. L'examen clinique et l'enregistrement des profondeurs de poche (PPD) et du niveau d'attache (CAL) furent réalisés avant le traitement (T0), 3 mois après la fin du traitement actif (T1) et chaque année aux rendez vous de maintenance (T2,T3,T4,T5). Des échantillons microbiologiques furent prélevés lors de la maintenance à 5 ans (T5). La plaque sous-gingivale de chaque patient fut prélevée d'une poche profonde (>5mm), sur la base des examens initiaux, choisis au hasard dans chaque quadrant. Les niveaux d' Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis et Treponema denticola furent déterminés par hybridation par sonde d'oligonucleotides. Résultats: pendant la période d'examination de 5 ans, la moyenne des SPC par patient fut de 12.7 sessions. Une amélioration significative fut observée pour PPD, CAL, l'indice de saignement gingival et la suppuration suite au traitement. Cependant, entre T1 et T5, 134 sites chez 20 patients connurent une détérioration avec une perte d'attache de 2 mm. De ces 134 sites qui présentaient une progression de la maladie, des échantillons microbiologiques furent obtenus aléatoirement dans 13 sites (9.7%) chez 8 patients. Parmi d'autres facteurs, le tabagisme et le stress furent reconnus comme ayant une significative valeur prédictive pour de futures pertes d'attache. P. gingivalis, T. denticola et la charge bactérienne totale étaient de façon statistiquement significatif plus importants chez les patients chez qui la maladie progressait au cours des 5 ans de maintenance. Conclusions: pour la plupart des patients atteints d' EOP, des soins parodontaux de soutien réguliers sont efficaces pour maintenir les améliorations cliniques et microbiologiques obtenus par le traitement actif. Cependant, un petit pourcentage de sites progressait chez 20 patients. Les variables en ralation avec cette progression étaient la présence et aussi un comptage important de P. gingivalis, T. denticola et la charge bactérienne totale, le nombre d'épisodes aigus le nombre de dents perdues le tabagisme et le stress. [source] Accumulation of methylglyoxal in the gingival crevicular fluid of chronic periodontitis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2003S. Kashket Abstract Background, aims: Methylglyoxal (MG), a toxic product of cellular metabolism, is elevated in tissues and fluids in a number of human diseases. A cross-sectional study was undertaken to determine whether MG accumulates in the gingival crevicular fluid (GCF) of chronic periodontitis patients. Methods: GCF samples were collected for 30 s each from three teeth with pocket depths greater than 3 mm (DD sites), from 14 chronic periodontitis patients. Control samples were taken from three healthy sites (DH sites) in the same patients, as well as from seven subjects who were periodontally healthy (HH sites). Fluid volumes were determined and the strips were placed in 0.5 N perchloric acid. Subsequently, samples were derivatized with o -phenylenediamine and the resulting methylquinoxaline was assayed by high-performance liquid chromatography on Lichrospher® -100 RP-18, with UV detection. Results: Mean pocket depths were 5.7±0.7, 2.7±0.6 and 2.7±0.5 mm (mean±SD) for the DD, DH and HH sites, respectively. Mean MG levels were found to be 208.7±241.7 and 142.9±235.7 pmol/site in the GCF from DD and DH sites, respectively (p=0.0023), but only 11.5±4.4 pmol/site for the HH sites. Bacteroides forsythus has been found to accumulate high levels of MG in culture (unpublished data) and, consistent with this, the sampled diseased sites contained higher levels of B. forsythus than the corresponding healthy sites (2.7±4.2×105 versus 0.7±1.1×105, respectively; p=0.022). Total "red complex" microorganisms were significantly elevated in the DD sites. Conclusions: In view of the known protein- and DNA-modifying effects of MG, the finding of elevated levels of MG in the GCF from chronic periodontitis patients supports the hypothesis that MG may contribute to destructive tissue damage in this disease. Zusammenfassung Hintergrund: Methylglyoxal (MG), ein toxisches Produkt des Zellstoffwechsels, ist bei einer Reihe menschlicher Erkrankungen in Geweben und Körperflüssigkeiten erhöht. Zielsetzung: Querschnittsstudie zur Klärung der Frage, ob sich MG in der Sulkusflüssigkeit (SF) bei Patienten mit chronischer Parodontitis ansammelt. Methoden: Bei 14 Patienten mit chronischer Parodontitis wurde SF für 30 s an 3 Zähnen mit Sondierungstiefen >3 mm (DD-Stellen) gewonnen. Kontrollproben wurden von jeweils 3 gesunden Stellen (DH-Stellen) bei den gleichen Patienten und bei 7 parodontal gesunden Personen gewonnen (HH-Stellen). Die Flüssigkeitsvolumina wurden bestimmt und die Probenstreifen in 0,5 N Perchlorsäure gegeben. Anschließend wurden die Proben mit o-Phenyldiamin versetzt und das resultierende Methylquinoxalin wurde mittels High-Performance-Liquid-Chromatographie in einem Lichrospher®-100 RP-18 bei UV-Detektion nachgewiesen. Ergebnisse: Die mittleren Sondierungstiefen lagen bei 5,7±0,7, an den DD-Stellen, bei 2,7±0,6 (DH) und 2,7±0,5 mm (Mittelwert + Standardabweichung) (HH). Die mittleren MG-Spiegel lagen bei 208,7±241,7 an den DD-Stellen und bei 142,9±235,7 pmol/Stelle an den DH-Stellen (p=0,0023), aber nur bei 11,5±4,4 pmol/Stelle an den HH-Stellen. Es war gezeigt worden, dass Bacteroides forsythus in Kultur hohe Konzentrationen von MG ansammelt (unveröffentlichte Daten) und übereinstimmend damit wurden an den untersuchten DD-Stellen höhere Zahlen von B. forsythus gefunden als an den entsprechenden gesunden Stellen (2,7±4,2×105 versus 0,7±1,1×105; p=0,022). Die Zahl aller Keime des "Roten Komplexes" waren an DD-Stellen signifikant erhöht. Schlussfolgerungen: In Anbetracht der bekannten Proteine und DNS verändernden Effekte von MG unterstützt dieser Nachweis erhöhter MG-Spiegel in der SF bei Patienten mit chronischer Parodontitis die Hypothese, dass MG zur Gewebezerstörung bei Parodontitis beiträgt. Résumé Références et buts: Le méthylglyoxal (MG), un produit toxique du métabolisme cellulaire est retrouvé en quantitéélevée dans les tissus et les fluides lors de nombreuses maladies humaines. Une étude croisée fut réalisée pour déterminer si MG s'accumulait dans le fluide gingival (GCF) des patients atteints de parodontite chronique. Méthodes: Des échantillons de GCF furent prélevés pendant 30 secondes chacun de 3 dents avec des profondeurs de poches de plus de 3 mm (sites DD), chez 14 patients atteints de parodontites chroniques. Des échantillons contrôles furent prélevés sur des sites sains (sites DH) chez les mêmes patients, et aussi chez 7 sujets au parodonte sain (sites HH). Les volumes de fluide furent déterminés et les bandelettes ont été mises dans 0.5 N d'acide perchlorique. Puis, les échantillons furent transformés à l'aide de o-phenylenediamine et la méthylquinoxaline ainsi créée fut analysé par chromatographie liquide à haute performance sur une Lichrospher®-100 RP-18, avec détection aux UV. Résultats: Les profondeurs de poche moyenne étaient de 5.7 ± 0.7, 2.7 ± 0.6 et 2.7±0.5 mm (moyenne ± SD) pour les sites DD, DH et HH, respectivement. Les niveaux moyen de MG étaient de 208.7±241.7 et 142.9±235.7 pmol/site dans le fluide des sites in DD et DH, respectivement (p=0.0023), mais seulement de 11.5±4.4 pmol/site pour les sites HH. On a trouvé que Bacteroides forsythus accumulait de hauts niveaux de MG en culture (données non publiées) et les sites malades échantillonnés contenait effectivement de plus hauts niveaux de B. forsythus que les sites sains correspondants (2.7±4.2×105 contre 0.7±1.1×105, respectivement; p=0.022). Les microorganismes du complexe rouge étaient significativement en nombre élevé dans les sites DD. Conclusions: Au vu des effets connus de MG pour modifier les protéines et l'AND, la découverte de niveaux élevés de MG dans le fluide gingival de patients atteints de maladie parodontale chronique supporte l'hypothèse selon laquelle MG pourrait contribuer aux dommages tissulaires destructifs rencontrés au cours de cette maladie. [source] HHV-6, HHV-7, HHV-8 in gingival biopsies from chronic adult periodontitis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2003A case, control study Abstract Background: Recent reports have suggested that various herpesviruses may be involved in the occurrence and progression of different forms of periodontal disease. Objective: The objective of the present study was to investigate the presence of the novel herpesviruses HHV-6, HHV-7 and HHV-8 in gingival biopsies from patients affected by chronic adult periodontitis. As control, gingival biopsies from periodontally healthy subjects were analysed. Materials and methods: Gingival biopsies were harvested from 23 volunteers: 13 patients affected by chronic adult periodontitis (CAP) and 10 periodontally healthy subjects. Each CAP patient contributed two biopsies involving the epithelium and connective tissue facing the sulcus/periodontal pockets: one biopsy from a site having a probing pocket depth (PPD) 5 mm and presenting with bleeding upon probing (affected site) at the time of biopsy collection, and the other biopsy from a site with PPD3 mm and without bleeding on probing (nonaffected site). After DNA extraction, nested PCR was used in herpesvirus identification. Results: HHV-6 DNA sequences were detected in one non-affected site (8%) and no affected sites (0%) of CAP patients. One biopsy (10%) in healthy subjects revealed HHV-6 positivity. Tissue specimens in 10/13 CAP patients (77%) and 7/10 healthy subjects (70%) contained HHV-7 DNA. HHV-7 prevalence in affected and nonaffected sites of CAP patients was 77% and 54%, respectively. HHV-8 was detected in 7.7% of CAP patients and 0% of healthy subjects. Conclusions: Gingival tissue may act as a reservoir for HHV-7. A high prevalence of HHV-7 was detected in both periodontally diseased and healthy individuals. The prevalence of HHV-6 and -8 was similarly low in both groups. Our data do not support an association of investigated herpesvirus species with destructive periodontal disease. Zusammenfassung Hintergrund: Kürzliche Studien haben angedeutet, dass verschiedene Herpesviren bei der Entstehung und Progression verschiedener Formen der parodontalen Erkrankungen involviert sein könnten. Ziel: Das Ziel der vorliegenden Studie war die Untersuchung einer Präsenz von neuen Herpesviren HHV-6, HHV-7 und HHV-8 in gingivalen Biopsien von Patienten mit chronischer Erwachsenen-Parodontitis. Als Kontrollen dienten gingivale Biopsien von parodontal gesunden Personen. Material und Methoden: Gingivale Biopsien wurden von 23 Freiwilligen, 13 Patienten mit chronischer Erwachsenen-Parodontitis (CAP) und 10 parodontal gesunden Personen gesammelt. Von jedem CAP Patient wurden zwei Biopsien mit Epithel und Bindegewebe von der parodontalen Tasche genommen: eine Biopsie von einer Fläche mit einer Sondierungstiefe (PPD) , 5 mm und positiver Provokationsblutung (geschädigte Fläche) zur Zeit der Biopsieentnahme, die andere Biopsie von einer Fläche mit einer PPD , 3 mm und ohne Provokationsblutung (nicht geschädigte Fläche). Nach der DNA-Extraktion wurde die PCR zur Virusidentifikation benutzt. Ergebnisse: HHV-6 DNA-Sequenzen wurden in einer nicht geschädigten Fläche gefunden (8 %) und bei keiner geschädigten Fläche (0 %) von CAP-Patienten. Eine Biopsie (10 %) bei gesunden Personen war HHV-6 positiv. Gewebeproben von 10/13 CAP Patienten (77 %) und von 7/10 gesunden Personen (70 %) enthielten HHV-7 DNA. Die HHV-7 Prävalenz in geschädigten und nicht geschädigten Flächen von CAP Patienten war 77 % und 54 %. HHV-8 wurde in 7,7 % der CAP Patienten und bei 0 % der gesunden Personen gefunden. Zusammenfassung: Gingivales Gewebe kann als Reservoir für HHV-7 dienen. Eine hohe Prävalenz von HHV-7 wurde sowohl bei parodontal erkrankten als auch bei gesunden Personen gefunden. Das Vorkommen von HHV-6 und HHV-8 war in beiden Gruppen ähnlich. Unsere Daten unterstützen eine Beziehung der untersuchten Herpesviren mit destruierenden parodontalen Erkrankungen nicht. Résumé Des rapports récents ont suggéré que différents virus de l'herpès pouvaient être associés à l'apparition et la progression de différentes formes de la maladie parodontale. Le but de l'étude présente a été d'analyser la présence des virus herpétiques HHV-6, HHV-7 et HHV-8 dans des biopsies gingivales provenant de patients atteints de parodontite chronique de l'adulte. Comme contrôle, des biopsies gingivales de patients sains du point de vue parodontal ont été analysées. Des biopsies gingivales ont été prélevées de 23 volontaires, 13 souffrant de parodontite chronique (CAP) et 10 sains. Chaque patient CAP procuraient deux biopsies comprenant l'épithélium et le tissu conjonctif en face des poches parodontales/sillons : une biopsie provenant d'un site avec une profondeur de poche au sondage (PPD) 5mm et présentant un saignement au sondage (site touché) au moment du prélèvement de la biopsie, l'autre biopsie provenait d'un site avec PPD 3 mm sans saignement au sondage (site sain). Après extraction de l'ADN le PCR a été utilisé pour l'identification des virus herpétiques. Des séquences ADN HHV-6 ont été détectées dans un site sain (8%) mais dans aucun site touché (0%) chez les patients CAP. Une biopsie (10%) chez les sujets sains était HHV-6 positive. Les spécimens tissulaires de dix des treize patients CAP (77%) et sept des dix patients sains (70%) avaient de l'ADNHHV-7. La fréquence globale de HHV-7 dans les sites sains et touchés des patients CAP étaient respectivement de 77 et 54 %. HHV-8 était détecté chez 7,7 % des patients CAP et 0% des patients sains. Le tissu gingival peut servir de réservoir au HHV-7. Une importante fréquence globale de HHV-7 était détectée tant chez les individus sains que chez ceux avec parodontite. La fréquence globale de HHV-6 et HHV-8 était pareillement faible dans les deux groupes. Ces données ne défendent pas la thèse d'une association des virus herpétiques étudiés à la maladie parodontale destructrice. [source] The presence of local and circulating autoreactive B cells in patients with advanced periodontitisJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2002Tord Berglundh Abstract Aim: The aim of the present investigation was to study the local (gingival) and systemic occurrence of autoreactive B cells (CD5+CD19 positive) in subjects with a high or low susceptibility to periodontitis. Material and Methods: 2 groups of subjects (Group A and B) susceptible to periodontitis were included. Group A consisted of 22 adult patients (7 females and 15 males, aged 24,66 years) with advanced and generalized chronic periodontitis and group B comprised 7 children (4 girls and 3 boys aged 9,13 years) with localized aggressive periodontitis. 26 periodontally healthy subjects, Group C (aged 23,80 years, mean 49.6±16.3), were also recruited. Assessment of clinical and radiographical characteristics of periodontal disease was performed. Gingival biopsies and peripheral blood samples were obtained and prepared for immunohistochemical analysis. Blood samples only were obtained from the periodontally healthy subjects (group C). Results: The proportion of autoreactive B cells (CD5+CD19 positive) of peripheral blood lymphocytes was about 6 times higher in group A and 4 times higher in group B than in the samples from the control subjects (group C). About 40,50% of the B cells in the peripheral blood of the periodontitis susceptible individuals expressed markers for autoreactive features while less than 15% of the circulating B cells in the subjects of group C exhibited such markers. The periodontitis lesion in the adult periodontitis patients contained a substantial number of B cells out of which about 30% demonstrated autoreactive features. Conclusion: It is suggested that both circulating and local B cells in periodontitis susceptible individuals have a higher propensity to autoreactive properties than B cells of patients with a low susceptibility to periodontitis. Zusammenfassung Zielsetzungen: Untersuchung des lokalen (in der Gingiva) und systemischen Vorkommens autoreaktiver B-Zellen (CD5 und CD19 positiv) bei Individuen mit hoher und niedriger Anfälligkeit für Parodontitis. Material und Methoden: 2 Gruppen von Personen, die anfällig für Parodontitis waren, nahmen an der Studie teil: Gruppe A: 22 erwachsenen Patienten (im Alter von 24,66 Jahren; 7 weiblich) mit fortgeschrittener generalisierter chronischer Parodontitis; Gruppe B: 7 Kinder (9,13 Jahre; 4 Mädchen) mit lokalisierter aggressiver Parodontitis. Zusätzlich wurden 26 parodontal gesunde Personen (23,80 Jahre) untersucht. Klinische und röntgenologische parodontale Parameter wurden erhoben. In den Gruppen A und B, wurden Gingivabiopsien und periphere Blutproben, in Gruppe C nur Blutproben entnommen. Ergebnisse: Der Anteil autoreaktiver B-Zellen an den Lymphozyten im peripheren Blut war etwa 6 mal höher in gruppe A und 4 mal höher in Gruppe B als in Proben der Kontrollgruppe (Gruppe C). Etwa 40,50% der B-Zellen im peripheren Blut der für Parodontitis anfälligen Patienten exprimierten Marker für autoreaktive Eigenschaften während weniger als 15% der zirkulierenden B-Zellen der Individuen aus Gruppe C solche Marker aufwiesen. Die parodontalen Läsionen der erwachsenen Parodontitispatienten enthielten eine hohe Zahl von B-Zellen, von denen etwa 30% autoreaktive Eigenschaften aufwiesen. Schlussfolgerungen: Sowhol lokale als auch zirkulierende B-Zellen von für Parodontitis anfälligen Patienten zeigen mit größerer Häufigkeit autoreaktive Eigenschaften als die B-Zellen von Patienten mit geringer Parodontitisanfälligkeit. Résumé But: Le but de cette recherche était d'étudier la présence locale (gingivale) et systémique de cellules B auto réactives (CD5+CD19 positives) chez des sujets présentant une forte ou une faible susceptibilitéà la parodontite. Matériaux et méthodes: 2 groupes de sujet (A et B) susceptible à la parodontite furent inclus. Le groupe A était constitué de 22 patients adultes (7 femmes et 15 hommes âgés de 24 a 66 ans) présentant une parodontite chronique avancée et généralisée et le groupe B était constitué de 7 enfants (4 filles et 3 garçons ages de 9 à 13 ans) présentant une pardontite agressive localisée. 26 sujets sains d'un point de vue parodontal (groupe C, âgés de 23 à 80 ans, age moyen 49.6±16.3) furent également recrutés. L'observation des caractéristiques cliniques et radiographiques de la maladie parodontale fut réalisée. Des biopsies gingivales et des échantillons sanguins furent prélevées et préparées pour des analyses immunohistochemiques. Seuls des prélèvements sanguins furent pris sur le groupe des patients sains. Résultats: La proportion de cellules B auto réactives (CD5+CD19 positives) des lymphocytes du sang périphérique était 6× plus élevée dans le groupe A et 4× plus élevée dans le groupe B que chez les sujets contrôles du groupe C. Environ 40 a 50% des cellules B du sang périphérique des individus susceptibles à la parodontite exprimaient des marqueurs pour des caractéristiques auto réactives alors que moins de 15% des cellules B circulantes des sujets du groupe C présentaient de tels marqueurs. La lésion parodontale de patients atteints de parodontite de l'adulte contenait un nombre substantiel de cellule B parmi lesquels environ 30% présentaient des caractéristiques auto réactives. Conclusions: Cela suggère que les cellules B locales et circulantes des individus susceptibles à la maladie parodontale aient une puls grande propension aux propriétés auto réactives que les cellules B des patients ayant une susceptibilité faible à la parodontite. [source] The effects of subgingival calculus on the clinical outcomes of locally-delivered controlled-release doxycycline compared to scaling and root planingJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2002Lonnie R. Johnson Abstract Background, aim: The effect of subgingival calculus on the clinical outcomes of the local delivery of antimicrobials is unknown. This study examines the clinical outcomes of treatment with locally delivered controlled-release doxycycline (DH) or scaling and root planing (SRP) in subsets of adult periodontitis patients with known baseline levels of subgingival calculus. Methods: The data examined were obtained from 393 patients who participated in 2 multi-center trials. All patients had baseline subgingival calculus levels assessed and were then treated at baseline and month 4 with either DH or SRP. Clinical attachment levels (CAL), pocket depth (PD) and bleeding on probing (BOP) were assessed at baseline and months 1, 2, 4, 5, 6, 8 and 9. Results: Treatment with either DH or SRP resulted in significant statistical and clinical improvements in CAL, PD and BOP. These clinical outcomes were equivalent regardless of the extent of subgingival calculus present at baseline. Conclusions: The results indicate that the primary clinical effects of these therapies are the result of a disruption and reduction of the subgingival plaque and not the effect of the removal of subgingival calculus and contaminated cementum. Zusammenfassung Hintergrund, Ziel: Der Effekt von subginvalem Zahnstein auf die klinischen Ergebnisse von lokal freigesetzten antimikrobiellen Mitteln ist unbekannt. Die Studie überprüfte die klinische Ergebnisse der Behandlung mit kontrolliert lokal freigesetztem Doxycyclin (DH) oder mit Wurzelreinigung und -glättung (SRP) bei einer Gruppe von Patienten mit Erwachsenen-Parodontitis mit bekanntem Ausmaß von subgingivalen Zahnstein zu Beginn der Studie. Methoden: Die zu überprüfenden Daten kamen von 393 Patienten, die an 2 multizentrischen Studien teilnahmen. Alle Patienten hatten zur Basis gemessene subgingivale Zahnsteinlevel, und sie wurden dann zur Basis und zum 4. Monat entweder mit DH oder SRP behandelt. Die klinischen Stützgewebeniveaus (CAL), die Sondierungstiefe (PD) und die Provokationsblutung (BOP) wurden zur Basis und zu den Monaten 1, 2, 4, 5, 6, 8 und 9 aufgezeichnet. Ergebnisse: Die Behandlung entweder mit DH oder SRP ergab statistisch signifikante und klinische Verbesserungen beim CAL, bei der PD und bei der BOP. Diese klinischen Ergebnisse waren unabhängig vom Ausmaß des subgingivalen Zahnsteins, der zur Basis vorhanden war, gleich. Schlussfolgerung: Die Ergebnisse zeigen, dass die primären klinischen Effekte von diesen Therapieformen das Resultat der Zerstörung und Reduktion der subgingivalen Plaque sind und nicht den Effekt von der Entfernung des subgingivalen Zahnsteins und kontaminierten Zementes darstellen. Résumé Origine, but: Les effets du tartre sous-gingival sur les comportements cliniques de l'application locale d'antimicrobiens sont inconnus. Cette étude examine le comportement clinique de traitement consistant en l'application locale de doxycycline à libération lente (DH) ou en un détartrage/surfaçage radiculaire seul (SRP) dans des groupes de patients atteints de parodontite de l'adulte avec des niveaux initiaux de tartre sous-gingival connus. Méthodes: Les données examinées sont obtenus chez 393 patients qui participèrent à 2 essais multi-centriques. Chez tous les patients, les niveaux de tartre sousgingivaux initiaux furent évalués et ils furent traités à 0 et à 4 mois avec soit DH, soit SRP. Les niveaux d'attache clinique (CAL), les profondeurs de poche (PD) et le saignement au sondage (BOP) furent évalués initialement et à 1, 2, 4, 5, 6, 8 et 9 mois. Résultats: Le traitement avec les 2 méthodes apportait des améliorations statistiquement significatives pour CAL, PD et BOP. Ces comportements cliniques étaient équivalents quel que fut l'importance du tartre sous-gingival initialement. Conclusions: Les résultats indiquent que les effets cliniques primaires de ces traitements sont le résultat de la réduction et de la désorganisation de la plaque sous-gingivale et non pas l'effet de l'élimination du tartre sous-gingival et du cément contaminé. [source] Quantitative analysis of MRP-8 in gingival crevicular fluid in periodontal health and disease using microbore HPLCJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2001Fionnuala T. Lundy Abstract Background: The protein components of GCF can be separated by reverse-phase microbore HPLC on a C18 column with detection on the basis of 214 nm absorbance. A single major symmetrical protein peak eluting with a retention time of 26 min (50% acetonitrile) was evident in gingival crevicular fluid (GCF) from periodontitis patients but not in healthy GCF. This protein was identified as human MRP-8 by N-terminal amino acid sequencing and liquid chromotography quadropole mass spectrometry. Aims: To quantify the amount of MRP-8 detectable in GCF from individual healthy, gingivitis and periodontitis affected sites and to study the relationship, if any, between the levels of this responsive protein and periodontal health and disease. Methods: GCF was sampled (30 s) from healthy, gingivitis, and periodontitis sites in peridontitis subjects (n=15) and from controls (n=5) with clinically healthy gingiva and no periodontitis. Purified MRP-8 was sequenced by Edmann degradation and the phenylthiohydantoin (PTH) amino acid yield determined (by comparison of peak area with external PTH amino acid standards). This value was subsequently used to calculate the relative amount of protein in the peak eluting with a retention time of 26.0 min (MRP-8) in individual GCF chromatograms. Results: Higher levels of MRP-8 were detected in inflammatory sites: periodontitis 457.0 (281.0) ng; gingivitis 413.5 (394.5) ng compared with periodontally healthy sites in diseased subjects 14.6 (14.3) ng and in controls 18.6 (18.5) ng, p=0.003. There was at least 20-fold more MRP-8 in the inflammatory compared with the healthy sites studied. Conclusions: The preliminary data indicate that MRP-8 is present in GCF, with significantly greater amounts present at diseased than healthy sites. A systematic study of the relationship of this protein to periodontal disease could prove useful in further clarifying whether MRP-8 could be a reliable GCF biomarker of gingivitis and periodontitis. Zusammenfassung Grundlagen: Der Proteingehalt des GCF, abgetrennt werden mit einer reversphasigen Microbore-HPLC auf einer C18-Säule mit Detektion auf der Basis der Absorption von 214 nm. Ein einziges symmetrisches Protein-Hauptpeak-Eluat, der mit einer Retentionszeit von 26 Minuten eluiert wurde (50% Acetonnitril) war in gingivalen Sulkusfluid (GCF) von Parodontitispatienten deutlich sichtbar, jedoch nicht im GCF von Gesunden. Dieses Protein wurde mitels N-terminaler Aminosären-Sequenzierung und Flüssigkeits-Chromatographie mit Quadropol-Massenspektrometrie als humanes MRP-8 identifiziert. Ziele: Quantifizierung der Menge an MRP-8, die im GCF von gesunden Personen, Patienten mit Gingivitis und mit Parodontitis nachweisbar ist und Studieren der eventuell möglichen Beziehungen zwischen den Titern dieses Reaktionsproteins und parodontaler Gesundheit bzw. Erkrankung. Methoden: Bei Parodontitispatienten (n=15) wurde das GCF von gesunden Bereichen, sowie von Stellen mit Gingivitis und Parodontitis gewonnen (30 Sek.) sowie bei Kontrollpersonen (n=5) mit klinisch gesunder Gingiva und ohne Parodontitis. Das gereinigte MRP-8 wurde mittels Edman-Degradierung Sequenziert und der Phenyl-Thiohydantoin (PTH) Aminosäure-Yield bestimmt (durch Vergleich der Peakbereiche mit externen PTH Aminosäurestandards). Darauffolgend wurde dieser Wert verwendet, um die relative Menge des Proteins im Peak-Eluat mit einer Retentionszeit von 26.0 Min. (MRP-8) in den individuellen Chromatogrammen zu berechnen. Ergebnisse: An entzündeten Stellen wurden höhere Titer von MRP-8 nachgewiesen: Parodontitis 457.0 (281.0) ng; Gingivitis 413.5 (394.5) ng verglichen mit parodontal gesunden Stellen bei erkrankten Patienten 14.6 (14.3) ng und den Kontrollen 18.6 (18.5) ng, p=0.003. An den entzündeten Stellen gab es im Vergleich mit den gesunden Stellen wenigstens 20 mal mehr MRP-8. Schlußfolgerungen: Die vorläufigen Daten zeigen, daß MRP-8 im GCF vorhanden ist und an erkrankten Stellen signifikant höhere Mengen vorhanden sind, als an gesunden Stellen. Eine systematische Studie der Beziehung dieses Proteins zur Parodondalerkrankung könnte sich als nützlich erweisen, um des weiteren zu klären, ob MRP-8 eine verläßlicher Biomarker für Gingivitis und Parodontitis ist. Résumé Origine: Les composants proéiques du fluide gingival peuvent être séparés par HPLC microbore en phase inverse sur une colonne C18 avec une détection sur une base d'absorption de 214 nm. Un unique pic majeur symétrique ayant un temps de rétention de 26 min (50% acetonitrile) était manifeste dans le fluide gingival (GCF) des patients atteints de parodontite, mais pas chez les patients sans. Cette protéine fut identifiée comme étant l'MRP-8 humaine après séquençage de l'acide aminé N terminal et spectrométrie de masse quadropole par chromatographie liquide. But: L'objectif est de quantifier la quantité de MRP-8 détectable dans le GCF de site sains, atteints de gingivite ou de parodontite et d'étudier, s'il y en a, la relation entre les niveaux de cette réponse protéique et la santé et la maladie parodontale. Méthodes: Le GCF frut prélevé (30 s) dans des sites sains, atteints de gingivite ou de parodontite, chez des sujets atteints de parodontite (n=15) ou chez des contrôles (n=5), ayant une gencive cliniquement saine sans parodontite. Le MRP-8 purifié fut séquencé par dégradation d'Edmann et le débit d'acide aminé phenylthiohydantoine (PTH) déterminé (par comparaison avec la surface de pic avec des standards d'acide aminé PTH externe). Cette valeur fut ensuite utilisée pour calculer la quantité relative de protéine dans le pic avec un temps de rétention de 26.0 mn (MRP-8) sur des chromatogrammes individuels de GCF. Résultats: De plus hauts niveaux de MRP-8 étaints détectés dans les sites inflammatoires: Parodontite 457.0 (281.0) ng; gingivite 413.5 (394.5) ng par rapport aux sites sains des sujets malades 14.6 (14.3) ng et des sujets contrôles 18.6 (18.5) ng, p=0.003. Il y avait au moins 20× plus de MRP-8 dans les sites inflammatoires par rapport au sites sains. Conclusions: Les données préliminaires indiquent que la MRP-8 est présente dans le GCF, en quantité significativement plus importante dans les sites malades. Une étude systèmatique de la relation entre cette protéine et la maladie parodontale pourrait se révéler utile pour encore plus expliciter si MRP-8 pourrait être un biomarqueur fiable du GCF des gingivites et des parodontites. [source] Tongue coating and salivary bacterial counts in healthy/gingivitis subjects and periodontitis patientsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2001S. Mantilla Gómez Abstract Background: The papillary structure of the dorsum of the tongue forms a unique ecological site that provides a large surface area favoring the accumulation of oral debris and microorganisms. These micro-organisms of the tongue may be of influence on the flora of the entire oral cavity. The normal appearance of the dorsum of the tongue is either pinkish or has a thin white coating. For the present study a scoring method was developed to describe the appearance of the dorsum of the tongue in relation to the extent of color and thickness of tongue coating. Aim: The purpose of this study was to investigate the discoloration and coating of the tongue in healthy/gingivitis subjects and periodontitis patients. Furthermore, to determine the relationship between the appearance of the tongue and the bacterial load in salivary samples. Material and Methods: 2 groups of patients were studied, 70 healthy/gingivitis subjects and 56 periodontitis patients. After scoring of the tongue a salivary sample of each patient was taken and analyzed using a phase-contrast microscope. Results: This investigation showed that most discoloration was found on the distal part of the tongue. The mean number of bacteria per ml sample in relation to a pink, white and yellow appearance of the tongue was 948, 855 and 900 (×106) respectively. The mean number of bacteria per ml sample in relation to no, thin and thick coating was 948, 863, and 895 (×106), respectively. Analysis did not reveal a relationship between discoloration, coating thickness and total bacterial load. The mean number of bacteria per ml in healthy/gingivitis subjects was 860 and in periodontitis patients 918 (×106). Conclusion: No relationship between the appearance of the tongue and salivary bacterial load could be detected. There was no difference in bacterial load between the healthy/gingivitis and the periodontitis group within the present study population. Zusammenfassung Hintergrund: Die papilläre Struktur des Zungenrückens bildet eine einheitliche ökologische Oberfläche, die eine große Oberfläche vermittelt, was die Akkumulation von oralem Belag und Mikroorganismen favorisiert. Diese Mikroorganismen der Zunge können die Flora der gesamten Mundhöhle beeinflussen. Die normale Erscheinung des Zungenrückens ist eher pinkfarben oder hat einen dünnen, weißen Belag. Für die vorliegende Studie wurde eine Meßmethode entwickelt, um die Erscheinung des Zungenrückens in Beziehung zum Ausmaß der Farbe und der Dicke des Zungenbelags zu beschrieben. Ziel: Der Zweck der Studie war die Untersuchung der Verfärbung und der Belagbildung auf der Zunge bei gesunden bzw. Gingivitis-Personen und Parodontitis-Patienten. Weiterhin sollte die Beziehung zwischen der Erscheinung der Zunge und dem bakteirellen Gehalt in Speichelproben bestimmt werden. Material und Methoden: 2 Gruppen von Patienten wurden untersucht, 70 gesunde bzw. Gingivitis-personen und 56 Parodontitis-Patienten. Nach der Beurteilung der Zunge wurde von jedem Patienten eine Speichelprobe genommen und mit einem Phasenkontrastmikroskop untersucht. Ergebnisse: Die Ergebnisse zeigten, daß die meiste Verfärbung der Zunge am distalen Teil gefunden wurde. Die mittlere Anzahl der Bakterien pro ml Speichel in Beziehung zu einer pinkfarbigen, weißen und gelben Erscheinung der Zunge was 948, 855 oder 900 (×106). Die mittlere Anzahl der Bakterien pro ml Speichel in Beziehung zu keinem, zu dünnem oder zu dickem Belag war 948, 863 oder 895 (×106). Die Analyse zeigte keine Beziehung zwischen Verfärbung, Belagsdicke und totalem Bakteriengehalt. Die mittlere Anzahl von Bakterien pro ml bei gesunden bzw. Gingivitis-Personen war 860 und bei Parodontitis-Patienten 918 (×106). Zusammenfassung: Es konnte kein Beziehung zwischen der Erscheinung der Zunge und dem bakteriellen Gehalt entdeckt werden. Es gab keine Differenzen im bakteriellen Gehalt zwischen den gesunden bzw. Gingivitis-Personen und den Parodontitis-Patienten innerhalb der vorliegenden Studienpopulation. Résumé Origine: La structure papillaire du dos de la langue forme un site écologique unique qui comporte une large surface favorisant l'accumulation de débris buccaux et de micro-organismes. Ces derniers peuvent avoir une influence sur la flore de l'ensemble de la cavité buccale. L'apparence normale du dos de la langue est rosée ou possède un très fin recouvrement blanc. Une méthode d'échellonnage a été développée afin de décrire l'apparence du dos de la langue en relation avec l'ampleur de la couleur et l'épaisseur du recouvrement de la langue. But: Le but de cette étude a été d'étudier la décoloration et le recouvrement de la langue chez des sujets sains/avec gingivite et parodontite. De plus la relation entre l'apparence de la langue et la charge bactérienne dans les échantillons salivaires a été déterminée. Matériaux et méthodes: 2 groupes de patients ont étéétudiés, 70 sujets sains ou avec gingivite et 56 patients avec parodontite. Après avoir évalué la langue, un échantillon salivaire de chaque patient a été prélevé et analysé en utilisant un microscope à contraste de phase. Résultats: Les résultats ont montré que la plupart de la décoloration était trouvée dans la partie distale de la langue. Le nombre moyen de bactéries par ml d'échantillon en relation avec la couleur rose, blanche ou jaune était respectivement de 948, 855 et 900 (×106). Le nombre moyen de bactéries par ml d'échantillon en relation avec un recouvrement inexistant, fin ou épais était respectivement de 948, 863 et 895 (×106). L'analyse n'a pas mis en évidence une relation entre la décoloration, l'épaisseur de recouvrement et la charge bactérienne totale. Le nombre moyen de bactéries par ml chez des sujets sains/gingivite était de 860 et chez les patients avec parodontite de 918 (×106). Conclusion: Aucune relation entre l'apparence de la langue et la charge bactérienne salivaire n'a donc pûêtre détectée. Il n'y avait aucune différence dans la charge bactérienne entre le groupe sain/gingivite et le groupe parodontite dans la population étudiée. [source] | ||||||||||